Individual
MRS. KELI ELIZABETH JORDAN-GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
8309 N KNOXVILLE AVE, PEORIA, IL 61615-2170
(309) 693-9540
(309) 693-9542
Mailing address
3055 WABASH AVE, SPRINGFIELD, IL 62704-6414
(217) 793-2273
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
468857
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7106766
BCBS
—
Enumeration date
07/26/2006
Last updated
07/25/2024
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